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Medicaid State Plan Amendments

A Medicaid and CHIP state plan is an agreement between a state and the Federal government describing how that state administers its Medicaid and CHIP programs. It gives an assurance that a state will abide by Federal rules and may claim Federal matching funds for its program activities. The state plan sets out groups of individuals to be covered, services to be provided, methodologies for providers to be reimbursed and the administrative activities that are underway in the state.

When a state is planning to make a change to its program policies or operational approach, states send state plan amendments (SPAs) to the Centers for Medicare & Medicaid Services (CMS) for review and approval. States also submit SPAs to request permissible program changes, make corrections, or update their Medicaid or CHIP state plan with new information.

Persons with disabilities having problems accessing the SPA PDF files may call 410-786-0429 for assistance.

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Showing 51 to 60 of 516 results
Transmittal Number: CO-22-0028
State: Colorado
Summary: To revise Colorado"s paper alternative single. streamlined application and the paper alternative application used for multiple human services programs.
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Medicaid and CHIP Program (MACPro)
Links:
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Transmittal Number: CO-23-0002
State: Colorado
Summary: Effective for services on or after January 1, 2023, this amendment authorizes payment for take home Naloxone dispensed by a hospital upon discharge to members deemed at risk of opioid related overdoses. Naloxone is exlcuded from the Diagnostic Related Group (DRG) relative weight calculation and will be paid according to the physician administered drugs payment methodology under the Attachment 4.19-B authority.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: CO-22-0038
State: Colorado
Summary: This plan amendment adds a Chronic Condition Episode-Based Incentive payment to Alternative Payment Methodology (APM) 1 and APM 2.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: CO-23-0009
State: Colorado
Summary: The state adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Medicaid and CHIP Program (MACPro)
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: CO-23-0013
State: Colorado
Summary: This plan amendment intends to make the 90% reimbursement of net invoice for outpatient hospital physician-administered drugs permanent.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: CO-23-0001-A
State: Colorado
Summary: This amendment adds a target group for children with developmental disabilities receiving services through the Early Intervention program for Targeted Case Management.
Approval Date:
Effective Date:
Topics:
  • Coverage and Reimbursement
Links:
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Transmittal Number: CO-23-0001
State: Colorado
Summary: This amendment add the populations served by the following 1915(c) HCBS waivers as target groups for Targeted

Case Management: Brain Injury (BI), Children's Home and Community Based Services (CHCBS),Children with Life Limiting Illness (CLLI) Complementary and Integrative Health (CIH), Community Mental Health Supports (CMHS), and Elderly, Blind, and Disabled (EBD).
Approval Date:
Effective Date:
Topics:
  • Coverage and Reimbursement
Links:
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Transmittal Number: CO-23-0006
State: Colorado
Summary: This amendment removes Prior Authorization Request requirements for Home Health Services.  Additionally, the SPA allows practitioners to order and re-order that the patient is eligible for Medicaid Home Health Services.
Approval Date:
Effective Date:
Topics:
  • Health Homes
Links:
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Transmittal Number: CO-23-0007
State: Colorado
Summary: This amendment allows the 240 service unit limit per client for targeted case management services to be exceeded if medically necessary.
Approval Date:
Effective Date:
Topics:
  • Targeted Case Management
Links:
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Transmittal Number: CO-22-0017
State: Colorado
Summary: Effective for services on or after July 1, 2022, this amendment implements supplemental payments to nursing facilities based on discharges and staff wages.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT